Compressive Pericardial Teratoma about a Case at Regional Hospital of Saint Louis/Senegal

Introduction: Cardiac tumors in children are rare. Most are discovered in children under one year of age. Echocardiography is the basic examination for the screening, it allows their detection from the fetal stage. Observation: She was a 14-year-old patient with no known history of pathology. She was admitted to our department for the exploration of dyspnea and chest pain. At her admission, she had stable hemodynamics. At cardiac auscultation, heart sounds were muffled. The EKG recorded a sinus rhythm, and negative T-waves from V1 to V4. The chest X-ray showed cardiomegaly and a dense, rounded, heterogeneous left hilar opacity, well limited. Echocardiography objected to a great intrapericardial mass in front of the left cardiac cavities compressing part of the left atrium and left ventricle associated with an important pericardial effusion. The CT scan found a heterogeneous pericardial suspected myxoma mass. The pathological examination confirmed pericardial teratoma. The patient had an excision of the pericardial mass. The evolution after surgery was favorable. Conclusion: Intra-pericardial teratomas are benign tumor. Complete removal of the tumor is curative and without recurrence.

CT Scans and Delays in Diagnosis of Stroke in Senegal’s Regional Hospitals: A Multicenter Study of 655 Cases

Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.